If you are taking a medication affected by cannabidiol, you should consult Any drug metabolized by CYP enzymes could potentially interact with cannabidiol . In other words, you ingest an inactive compound and once in the body, it is. Compounds in grapefruit inhibit the same enzyme group, which is why physicians advice patients not to eat grapefruit shortly before or after taking a medication. OTHER NAME(S). 2-[(1R,6R)Methylpropenylcyclohexenyl] pentylbenzene-1 ,3-diol, CBD. . Show More · Read Reviews (47).
Interactions with Potential Drugs Prescription Other CBD
These animal and human ex vivo studies have been reviewed extensively elsewhere, but studies with pure CBD are still lacking. It would be especially interesting to study when CBD is proinflammatory and under which circumstances it is anti-inflammatory and whether this leads to side effects Burstein, Table 1 shows a summary of its anti-inflammatory actions; McAllister et al. In case of Alzheimer's disease AD , studies in mice and rats showed reduced amyloid beta neuroinflammation linked to reduced interleukin [IL]-6 and microglial activation after CBD treatment.
This led to amelioration of learning effects in a pharmacological model of AD. The chronic study we want to describe in more detail here used a transgenic mouse model of AD, where 2. CBD was able to prevent the development of a social recognition deficit in the AD transgenic mice. Using statistical analysis by analysis of variance, this was shown to be only a trend. This might have been caused by the high variation in the transgenic mouse group, though.
This was probably due to already elevated cholesterol in the transgenic mice. The study observed no side effects. After CBD treatment was stopped, observation continued until the mice were 24 weeks old. CBD increased IL levels, which is thought to act as an anti-inflammatory cytokine in this context.
After inducing arthritis in rats using Freund's adjuvant, various CBD doses 0. CBD reduced joint swelling, immune cell infiltration. CBD was shown to be able to influence migratory behavior in cancer, which is also an important aspect of embryogenesis. Helix-loop-helix Id proteins play a role in embryogenesis and normal development via regulation of cell differentiation. High Id1-levels were also found in breast, prostate, brain, and head and neck tumor cells, which were highly aggressive.
In contrast, Id1 expression was low in noninvasive tumor cells. Id1 seems to influence the tumor cell phenotype by regulation of invasion, epithelial to mesenchymal transition, angiogenesis, and cell proliferation.
There only seems to exist one study that could not show an adverse CBD effect on embryogenesis. An in vitro study could show that the development of two-cell embryos was not arrested at CBD concentrations of 6. Various studies have been performed to study CBD anticancer effects. CBD every 3 days for a total of 28 weeks, almost completely reduced the development of metastatic nodules caused by injection of human lung carcinoma cells A in nude mice.
The typical side effects of traditional anticancer medication, emesis, and collateral toxicity were not described in these studies. Consequently, CBD could be an alternative to other MMP1 inhibitors such as marimastat and prinomastat, which have shown disappointing clinical results due to these drugs' adverse muscoskeletal effects. Two studies showed in various cell lines and in tumor-bearing mice that CBD was able to reduce tumor metastasis. CBD downregulated Id1 at promoter level and reduced tumor aggressiveness.
Moreover, to carry out these experiments, animals are often immunologically compromised, to avoid immunogenic reactions as a result to implantation of human cells into the animals, which in turn can also affect the results.
Another approach was chosen by Aviello et al. After 3 months, the number of aberrant crypt foci, polyps, and tumors was analyzed. The high CBD concentration led to a significant decrease in polyps and a return to near-normal levels of phosphorylated Akt elevation caused by the carcinogen. Animal studies summarized by Bergamaschi et al. Chronic administration 14 days, 2.
This effect could be inhibited by coadministration of a CB2R antagonist. The positive effects of CBD on hyperglycemia seem to be mainly mediated via CBD anti-inflammatory and antioxidant effects. In addition, treatment increased adiponectin and liver glycogen concentrations.
CBD showed inhibition of testosterone oxidation in the liver. Motor function was also tested on a rotarod, which was also not affected by CBD administration. Static beam performance, as an indicator of sensorimotor coordination, showed more footslips in the CBD group, but CBD treatment did not interfere with the animals' speed and ability to complete the test. Compared to other anticonvulsant drugs, this effect was minimal. CBD did not lead to adverse effects. In addition, psychomotor function and psychological functions were not disturbed.
Interestingly, the CYP2C19 inhibitor omeprazole, used to treat gastroesophageal reflux, could not significantly affect the pharmacokinetics of CBD. Unfortunately, it was not mentioned whether this effect was mediated via the cytochrome P complex. Another aspect, which has not been thoroughly looked at, to our knowledge, is that several cytochrome isozymes are not only expressed in the liver but also in the brain.
It might be interesting to research organ-specific differences in the level of CBD inhibition of various isozymes. Apart from altering the bioavailability in the overall plasma of the patient, this interaction might alter therapeutic outcomes on another level.
Generally, more human studies, which monitor CBD-drug interactions, are needed. In a double-blind, placebo-controlled crossover study, CBD was coadministered with intravenous fentanyl to a total of 17 subjects. This was followed by a single 0. This extensive tool tests, for example, 78 adverse effects divided into 23 categories corresponding to organ systems or body parts. No respiratory depression or cardiovascular complications were recorded during any test session.
The results of the evaluation of pharmacokinetics, to see if interaction between the drugs occurred, were as follows. No effect was evident for urinary CBD and metabolite excretion except at the higher fentanyl dose, in which CBD clearance was reduced. Importantly, fentanyl coadministration did not produce respiratory depression or cardiovascular complications during the test sessions and CBD did not potentiate fentanyl's effects.
No correlation was found between CBD dose and plasma cortisol levels. CBD did not worsen the adverse effects e. Coadministration was safe and well tolerated, paving the way to use CBD as a potential treatment for opioid addiction.
A Dutch study compared subjective adverse effects of three different strains of medicinal cannabis, distributed via pharmacies, using VAS. The 12 adjectives used for this study were as follows: This strain showed significantly lower levels of anxiety and dejection. Moreover, appetite increased less in the high CBD strain. The review by Bergamaschi et al. This holds especially true for the extrapyramidal motor side effects elicited by classical antipsychotic medication. Order of drug administration was pseudorandomized across subjects, so that an equal number of subjects received any of the drugs during the first, second, or third session in a double-blind, repeated-measures, within-subject design.
This effect was caused by opposite neural activation of relevant brain areas. In addition, no effects on peripheral cardiovascular measures such as heart rate and blood pressure were measured.
A randomized, double-blind, crossover, placebo-controlled trial was conducted in 16 healthy nonanxious subjects using a within-subject design. The doses were selected to only evoke neurocognitive effects without causing severe toxic, physical, or psychiatric reactions.
The physiological parameters, heart rate and blood pressure, were also monitored and no significant difference between the placebo and the CBD group was observed. A case study describes a patient treated for cannabis withdrawal according to the following CBD regimen: Hepatic enzymes were also measured daily, but no effect was reported. Naturalistic studies with smokers inhaling cannabis with varying amounts of CBD showed that the CBD levels were not altering psychomimetic symptoms.
CBD might work to alleviate disorders of addiction, by altering the attentive salience of drug cues. The study did not further measure side effects. CBD can also reduce heroin-seeking behaviors e. This was shown in the preclinical data mentioned earlier and was also replicated in a small double-blind pilot study with individuals addicted to opioids, who have been abstinent for 7 days.
One hour after the video session, subjective craving was already reduced after a single CBD administration. The effect persisted for 7 days after the last CBD treatment. Interestingly, anxiety measures were also reduced after treatment, whereas no adverse effects were described.
A pilot study with 24 subjects was conducted in a randomized, double-blind, placebo-controlled design to evaluate the impact of the ad hoc use of CBD in smokers, who wished to stop smoking.
Pre- and post-testing for mood and craving of the participants was executed. Craving was assessed using the Tiffany Craving Questionnaire On day 1 and 7, exhaled CO was measured to test smoking status. Sedation, depression, and anxiety were evaluated with the MRS. At day 7, the anxiety levels for placebo and CBD group did not differ. CBD did not increase depression in contrast to the selective CB1 antagonist rimonabant.
CBD might weaken the attentional bias to smoking cues or could have disrupted reconsolidation, thereby destabilizing drug-related memories. To the best of our knowledge, no acute studies were performed that solely concentrated on CBD glycemic effects. Moreover, the only acute study that also measured CBD effect on appetite was the study we described above, comparing different cannabis strains.
Growth hormone and prolactin levels were unchanged. Compared to the healthy individuals, the cortisol levels increased less after TSST in the 32 at-risk individuals. The CBD group showed less reduced cortisol levels but differences were not significant. Truly chronic studies with CBD are still scarce. Nonetheless, we also included these studies with repeated CBD treatment, because we think that compared to a one-time dose of CBD, repeated CBD regimens add value and knowledge to the field and therefore should be mentioned here.
These results are supported by another study described in the review by Grotenhermen et al. CBD was administered on average with three other drugs, including clobazam The coadministration led to an alteration of blood levels of several antiepileptic drugs. In the case of clobazam this led to sedation, and its levels were subsequently lowered in the course of the study.
A first pilot study in healthy volunteers in by Mincis et al. Clinical chronic lasting longer than a couple of weeks studies in humans are crucial here but were mostly still lacking at the time of writing this review.
They hopefully will shed light on the inconsistencies observerd in animal studies. Chronic studies in humans may, for instance, help to test whether, for example, an anxiolytic effect always prevails after chronic CBD treatment or whether this was an artifact of using different animal models of anxiety or depression.
In a 4-week open trial, CBD was tested on Parkinson's patients with psychotic symptoms. This led to a reduction of their psychotic symptoms.
Moreover, no serious side effects or cognitive and motor symptoms were reported. No adverse effects were observed and her symptoms improved. The same positive outcome was registered in another study described by Bergamaschi et al.
The respective treatment was maintained for three additional weeks. This was the case for three patients in the CBD group and five patients in the amisulpride group. CBD treatment was accompanied by a substantial increase in serum anandamide levels, which was significantly associated with clinical improvement, suggesting inhibition of anandamide deactivation via reduced FAAH activity. In addition, the FAAH substrates palmitoylethanolamide and linoleoyl-ethanolamide both lipid mediators were also elevated in the CBD group.
CBD showed less serum prolactin increase predictor of galactorrhoea and sexual dysfunction , fewer extrapyramidal symptoms measured with the Extrapyramidal Symptom Scale, and less weight gain.
Moreover, electrocardiograms as well as routine blood parameters were other parameters whose effects were measured but not reported in the study. CBD better safety profile might improve acute compliance and long-term treatment adherence.
A press release by GW Pharmaceuticals of September 15th, , described 88 patients with treatment-resistant schizophrenic psychosis, treated either with CBD in addition to their regular medication or placebo.
Important clinical parameters improved in the CBD group and the number of mild side effects was comparable to the placebo group. Information from these reports is conflicting. Case reports, case series and small studies are considered insufficient evidence to prove or disprove the safety and efficacy of a drug or treatment.
This is because these studies are usually unable to distinguish between the effect of a drug and a placebo effect , the patient thinking the drug is working when it really is not providing benefit. However, there are two well-designed, large studies that indicate CBD is effective in the two different epilepsy syndromes.
In these studies, about 40 percent of patients taking CBD had a significant reduction in specific types of seizures. Epilepsy is the only disorder where there is solid scientific evidence demonstrating that CBD is safe and effective. This does not mean that CBD will not work for other disorders, but epilepsy is the only one where we have clear, well-documented evidence that CBD helps. Results from these studies show that CBD does have side effects. The most common ones are drowsiness, nausea, intestinal cramping, bloating and diarrhea.
More serious side effects can occur. In one of the studies in epilepsy, about 10 percent of patients taking CBD had an increase in laboratory tests of liver function. These tests commonly indicate damage to the liver. About percent of patients taking CBD had to discontinue it due to large increases in certain liver enzymes in laboratory tests, showing possible liver damage. We are also learning about drug interactions that occur with CBD. In these studies, CBD slowed the metabolism of several drugs that are commonly given to individuals with epilepsy.
The interactions between CBD and other drugs patients were taking caused side effects. It is unclear if these side effects were due to CBD, the other drugs, or a combination. Doses of the other drugs were reduced, due to the interactions. The mechanism for these interactions indicate that there are likely several other interactions between CBD and other common medications.
Cannabidiol needs to be used cautiously in combination with other medications. There are several other factors to consider in regards to CBD.
Cannabidiol does not dissolve well in water. For this reason, oral products of CBD are made with an oil, often some type of vegetable oil. It is important that the right oil is used. Likewise, not every medication in each of the categories listed will cause an interaction with CBD oil. If you are worried that you P enzyme system may not be functioning properly, physicians can test the system to ensure that the medications you take are metabolizing as expected.
While this is well-intentioned advice and far better than not leaving any gap, this kind of advice is risky given the vastly different medications, conditions and situations people are in. The advice should be that anyone taking other medication should consult their doctor before supplementing CBD products.
A two-hour window is not enough time to guarantee that CBD and other medicines will not interact in a negative or dangerous way in your body. If you have already decided that CBD oil is right for you , then this is where your doctor comes in. There are a lot of reasons to take CBD and still need to take your prescriptions, even though half of the people who try CBD drop their prescriptions altogether.
Explain to your doctor why you think you need to take CBD and the concerns you have with how it may affect your medication. Your doctor can adjust your medication to work with CBD if needed. This is because they are not metabolized by the liver and instead enter the bloodstream through the lungs vaping and the skin CBD patches.
Always exercise caution when taking CBD along with other medications. While CBD is largely considered to be an incredibly safe and therapeutic supplement, there is still the possibility that it will have a negative impact when combined with other drugs.
If in doubt, do your research and make sure you are in the know about any potential side effects, however small they might be. Jennifer, author of Hybrid Rasta Mama, is a former government recruiter turned stay-at-home mama to a daughter brought earthside in early She is passionate about and writes about the benefits of CBD oil, coconut oil, toxic mold awareness, holistic health, and natural living.
She frequently shares allergy friendly recipes on her site as well as DIY herbal remedies, and natural cleaning recipes. Jennifer graduated with honors with a Bachelor's Degree in Ethnic Studies. In January she became a certified mold and moisture intrusion inspector.
She has completed coursework in the naturopathic series offered by the Avicenna Institute and accredited through the Board of Natural Medicine Certification Council. In addition, Jennifer is a certified CBD educator. Statements on this website have not been evaluated by the Food and Drug Administration.
How Does Cannabis Interact With Other Drugs?
reproductive and other risks associated with medical cannabis use. ( prescription Marijuana has low to moderate dependence potential; the active dose As CYP3A4 metabolizes about a quarter of all drugs, CBD may increase serum. Like any other treatment, though, there can be interactions with other meds. also create the potential for CBD to interact with other medications you might take . also take prescription medications for anxiety or other mental health conditions. Before moving on to discuss the potential interactions, we would like to remind In the case of use of any medication, not only a prescription drug, and not just those Other equally serious potential side can be caused by mixing CBD with.